Medical Director, Cardiology
Company: Evolent Health
Posted on: May 27, 2023
Your Future Evolves Here
New Century Health (NCH) has been transforming the delivery of specialty care and driving radical cost and quality improvement across the member journey for patients with cancer and cardiovascular disease. As part of Evolent Health, we are on a bold mission to change the health of the nation by changing the way health care is delivered. Evolenteers make a difference wherever they are, whether it is at a medical center, in the office, or while working from home across 48 states. We empower you to work from where you work best, which makes juggling careers, families, and social lives so much easier. Through our recognition programs, we also highlight employees who live our values, give back to our communities each year, and are champions for bringing their whole selves to work each day. If you're looking for a place where your work can be personally and professionally rewarding, don't just join a company with a mission. Join a mission with a company behind it.
Why We're Worth the Application:
We continue to grow year over year.
Recognized as a leader in driving important diversity, equity, and inclusion (DE&I) efforts (https://www.evolenthealth.com/diversity) .
Achieved a 100% score two years in a row on the Human Rights Campaign's Corporate Equality Index recognizing us as a best place to work for LGBTQ+ equality.
Named to Parity.org's list of the best companies for women to advance for 3 years in a row (https://www.evolenthealth.com/about-us/press-releases/9328/evolent-health-named-to-parity.org%E2%80%99s-best-companies-for-women-to-advance-list-2022) (2020, 2021 and 2022).
Continue to prioritize the employee experience and achieved a 90% overall engagement score on our employee survey in May 2022.
Publish an annual DE&I report (https://dev.evolenthealth.com/sites/default/files-public/Evolent%20Health%202020%20DE%26I%20Annual%20Report.pdf) to share our progress on how we're building an equitable workplace.
What You'll Be Doing:
This position is located in New Century Health's Brea office, just outside of Los Angeles.
The Medical Director, Cardiology is responsible for support and assistance for all Cardiology administrative and clinical utilization management and quality improvement functions under the auspices of the office of the Chief Medical Officer.
ESSENTIAL DUTIES AND RESPONSIBILITIES : include the following. Other duties may be assigned.
Responsible for implementation and maintenance of all clinical program guidelines. Responsible for participation in the Utilization Management (UM) Committee.
Responsible for performing peer reviews including peer-to-peer conversations.
Responsible for acting as a clinical liaison to providers, clients, and patients as directed by the office of the Chief Medical Officer.
Responsible for completion of UM projects and site visit reviews.
Responsible for overseeing clinical aspects of client site visits.
Responsible for communicating need for additional clinical information to ordering providers.
Responsible for supervising clinical reviewers.
Responsible for coordinating with UM staff to ensure timely and accurate communication of clinical decisions.
Respect and maintain HIPAA confidentiality guidelines.
Responsible for maintaining availability to clinical and non-clinical administrative staff during performance of initial and second level screening
Acts as an interdepartmental liaison between all New Century Health offices, departments, and committees.
Serve as subject matter expert and participate in meetings as assigned with practices and/or payers.
Will work with the Director of UM to ensure client satisfaction.
Perform all peer clinical review activities while located in a state or territory of the United States.
Acts with honor and integrity, serving as a role model for the company.
Performs other duties as assigned.
QUALIFICATION REQUIREMENTS : To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
EDUCATION and/or EXPERIENCE:
Graduate of recognized medical degree program. Minimum of five (5) years' experience in the practice of cardiology; knowledge of regulatory requirements with at least two years of experience in a regulatory role.
Current, unrestricted clinical license in medicine or required specialty.
Obtaining and maintaining medical licenses in the states where NCH has business
If trained after 1980, active Board Certification in Cardiology required.
OTHER SKILLS and ABILITIES:
Strong clinical, management, communication, and organizational skills.
Demonstrated leadership skills
Energetic and curious with a passion for quality and value in health care
Required to pass skills proficiency test
PHYSICAL DEMANDS : The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
While performing the duties of this job, the employee is regularly required to use hands to finger, handle, or feel objects, tools, or controls; reach with hands and arms; and talk or hear. The employee frequently is required to sit. The employee is occasionally required to stand and walk.
The employee must occasionally lift and/or move up to 25 pounds. Specific vision abilities required by this job include close vision.
WORK ENVIRONMENT : The work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
The noise level in the work environment is usually moderate.
We require that all employees have the following technical capability at their home: High speed internet over 10 Mbps, the ability to plug in directly to the home internet router. These at-home technical requirements are subject to change with any scheduled re-opening of our office locations.
Evolent Health is an equal opportunity employer and considers all qualified applicants equally without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, veteran status, or disability status.
Compensation Range: The minimum salary for this position is $-, plus benefits. Salaries are determined by the skill set required for the position and commensurate with experience and may vary above and below the stated amounts.
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For more insights about Evolent Health, click on Life At Evolent (https://www.evolenthealth.com/about-us/life-at-evolent) to learn more!
Your Future Evolves Here
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